Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $120.78 / $193.69 / $248.78	Facility	26	$120.78	$193.69	$248.78
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $166.06 / $396.63 / $396.63	Facility	26	$166.06	$396.63	$396.63
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $70.52 / $143.11 / $223.80	Facility	26	$70.52	$143.11	$223.80
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $113.23 / $171.14 / $174.20	Facility	26	$113.23	$171.14	$174.20
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $118.82 / $118.82 / $119.14	Facility	26	$118.82	$118.82	$119.14